Before and after bilateral DIEP flap breast reconstruction in a 53 year old woman. She had previously had bilateral skin sparing mastectomies followed by chemotherapy and left chest wall radiation. Her tissue expander on the left had become infected and required removal. She wanted to use her own body tissue for breast reconstruction. She was an ideal candidate for the DIEP flap!
Her right submuscular tissue expander was removed and both breasts were reconstructed using skin and fat from her lower abdomen. A secondary procedure was done a year later to reconstruct nipples and perform free fat grafting to her flaps, harvesting fat from her axillary rolls (armpit fat) and the sides of the breasts, upper and lower abdomen, flanks, back and upper inner thighs.
In my practice, more fat is usually harvested than is needed – this benefits the donor site and optimizes the aesthetics of the reconstructive procedure. My standards for breast reconstruction are just the same as for cosmetic procedures!
Follow up photos are shown a year a half after her DIEP flaps and 3 months after her fat grafting (lipofilling) and nipple reconstructions. She is nearly ready for nipple and areola tattoo, which will complete her reconstruction journey and allow her to move forward after breast cancer feeling completely whole again.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
